Abstract P-476: SEDATIVE WEANING AND DISCONTINUATION IN PEDIATRIC CRITICAL CARE: A SCOPING REVIEW
Bibliographic record
Abstract
Aims & Objectives: Discontinuing sedatives in children after critical illness is often challenging. Our objective in this scoping review was to identify and characterize the published literature focusing on sedative weaning and discontinuation in pediatric critical care – to understand the current research landscape, identify research gaps, and inform future systematic reviews. Methods We searched MEDLINE (inception to November 2017), including all types of publications in English that focused on sedative weaning and discontinuation in critically ill children. Pairs of reviewers independently screened studies for eligibility and abstracted data. Results We included 154 publications from 14 countries published in 66 journals. Sedative weaning or discontinuation was a major focus in 97 (63%) of the publications. The literature has grown from 1 publication in 1989 to 19 in 2017. 105 (68%) were original research, while 32% were reviews and editorials. There were 2 randomized trials that focused solely on sedative weaning and discontinuation. The publications clustered in 7 themes: strategies for sedative withdrawal management (64 [42%]), characterization of withdrawal symptoms (37 [24%]), topic overviews (29 [19%]), practice evaluation (12 [8%]), assessment tools (10 [6%]), patient or family impact (1 [1%]), and clinician attitudes (1 [1%]). Of the publications that specified author designation, 62 (54%) were from two or more professions, the remaining were authored by a single profession, most frequently physicians (34 [22%]). Conclusions The published body of literature on weaning and discontinuation of sedatives is diverse, increasing, and evolving. Researchers can use this scoping review to identify gaps in current literature and priorities for future research.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.087 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.006 |
| Bibliometrics | 0.020 | 0.019 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".